Assessment of HIV -I Transmission Risk from Blood Donors Screened Negative for HIV-I Antibody/Antigen by use of HI V-I DNA peR
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Date
2004-06
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Addis Ababa Universty
Abstract
The aim of this study was to assess tlte potential risk of trallsmission of Human
Immunodeficiency Virus type-i (HIV-i) by transfllsion of blood screened as negative
for HIV antigen (Ag)/antibody (Ab) in the Ethiopian Red Cross Society-National Blood
Transfllsioll Service (ERCS-NBTS) in Addis Ababa, Ethiopia. Assessment of risk
factors, test peljormance and efficiency of the HIV screening methods of the ERCSNBTS
laboratol)' (Ag/Ab EIA, Virol/ostika HIV Uni-Form II Ag/Ab) was made. A total
of 408 blood samples from unlinked one-time donations were collected and screened
for HIV-i illfection by [{sing Roche Amplicor V i.5 DNA PCR and discrepallt res lilts
were checked by Westem blot alld HII' RNA assays. Data analysis was done by using
STATA software. The cJ'llde prevalence of HI V-I illfection in blood do 1101'S as screened
by the ERSC-NBTS was 4.2%, while it was 3.4% as screened by nllcleic acid testillg.
Titus, nucleic acid testillg methods detected 3 false positive samples. All HIV-infected
donors were replacement donors. The fourth-generation assay lIsed at ERCS-NBTS
had an excellent test agreement with HIV-i DNA PCR assay. The validity oftlte Ag/Ab
EIA was vel)' high as depicted by its: sensitivity (JOO%), specificity (99.2%), test
efficiency (99.3%), positive predictive value (82.4%) and negative predictive vallie
(J OO%). Although no false negative blood unit was detected, it was shown that around
0.7% of the donated blood would be wrongly discarded as false positives. Tflis stlldy
has also provided good evidence for the need to introduce strong and improved dOllor
selection criteria. This would include, minimizing or exclusion of replace men I dOllars,
with an emphasis on recruitment of regular vohmtm), do 1101'S, and ellllcation of both
dOllors and the general public on tlte need for safe blood. Similar studies should be
done in other parts of the co/Inti)' before drawing a general conclusion abollt the
quality/safety of blood donatiolls in Ethiopia. Fllrther stlldies all HIV incidence among
blood donors, propel' estilllation of risk of HIV transmission through transfllsion, and
prevalence of HII' infection in transjilsion recipients are essential for monitoring the
safety of the blood supply. Studies on other transjilsion transmittable infectiolls agents
shollld also be IIndertake//.
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Keywords
HIV-I DNA PCR